Individual
DR. RAJIVI POTHIRAJ RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1250 S TAMIAMI TRL STE 302, SARASOTA, FL 34239-2221
(941) 877-5983
(941) 957-0079
Mailing address
1250 S TAMIAMI TRL STE 302, SARASOTA, FL 34239-2221
(941) 877-5983
(941) 957-0079
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
ME84160
FL
208000000X
Pediatrics Physician
ME84160
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004579100
—
FL
01
—
48958
FL BLUE
FL
01
—
KI170
MEDICARE
FL
Enumeration date
06/21/2005
Last updated
07/21/2020
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